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Robert J. Stratta, MD; Mark S. Shaefer, PharmD; Rodney S. Markin, MD, PhD; R. Patrick Wood, MD; Erin M. Kennedy, MD; Alan N. Langnas, DO; Elizabeth C. Reed, MD; Gail L. Woods, MD; Jeremiah P. Donovan, MD; Todd J. Pillen, PA; Robert M. Duckworth, CTPL; Byers W. Shaw, Jr, MD

Arch Surg. 1989;124(12):1443-1450.

Abstract
• During a 43-month period, we performed 248 liver transplantations in 211 patients (127 adults and 84 children). Cytomegalovirus (CMV) disease was documented in 73 recipients (34.6%). Risk factors for CMV disease included donor CMV seropositivity, antilymphocyte therapy, and retransplantation. The mean time of occurrence of CMV disease was 38.3 days after transplantation, and the most frequent site of disease was the hepatic allograft. A total of 69 patients were treated with intravenous ganciclovir, with a prompt and lasting response documented in 51 (73.9%). The remaining 18 (26.1%) developed recurrent CMV disease, which was more common after primary CMV exposure. Cytomegalovirus disease was ultimately controlled by ganciclovir in 94.2% of cases. This disease occurs early after transplantation and can be related to well-defined risk factors. Although ganciclovir therapy is effective, preliminary experience with prophylaxis shows promise in reducing the incidence of CMV disease.

(Arch Surg. 1989;124:1443-1450)

Author Affiliations
From the Departments of Surgery (Drs Stratta, Wood, Kennedy, Langnas, and Shaw and Messrs Pillen and Duckworth), Pharmacy Practice (Dr Shaefer), Medicine (Drs Reed and Donovan), Pathology and Microbiology (Drs Markin and Woods), University of Nebraska Medical Center, Omaha.

Footnotes
Accepted for publication August 24, 1989.

Read before the Ninth Annual Meeting of the Surgical Infection Society, Denver, Colo, April 14, 1989.

Reprint requests to Department of Surgery, University of Nebraska Medical Center, 42nd and Dewey Avenue, Omaha, Nebraska 68105 (Dr Stratta).

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